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Treatment of Localized Anal Cancer: Chemoradiotherapy

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Anal Cancer

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Abstract

Prior to the 1980s, surgery was the primary management of localized anal cancer. The concept of chemoradiotherapy was introduced in the neoadjuvant setting prior to abdominoperineal resection by Norman Nigro and colleagues at Wayne State University Hospital. Chemoradiotherapy with 5-fluorouracil, mitomycin C, and radiation therapy yielded complete pathologic responses obviating the need for surgery upfront. Attempts have been made to eliminate or change the chemotherapy used in the original Nigro regimen in attempts of minimizing toxicity; however, these trials often compromised outcomes. Acute side effects have been reduced with marked advancements in the delivery of radiation therapy using intensity-modulated radiation therapy (IMRT) and image guidance, where dose escalation is possible as a result of a reduced side effect profile. Using IMRT as a backbone, there are multiple ongoing and developing clinical trials attempting to improve the efficacy of treatment for locally advanced disease.

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Authors and Affiliations

  1. Harvard Radiation Oncology Program, Boston, MA, USA

    James Byrne

  2. Department of Radiation Oncology, Massachusetts General Hospital, Harvard University School of Medicine, Boston, MA, USA

    Jennifer Y. Wo

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  1. James Byrne
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  2. Jennifer Y. Wo
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Correspondence to Jennifer Y. Wo .

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Editors and Affiliations

  1. Department of Radiation Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Jeffrey Meyer

  2. Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA

    Lisa Kachnic

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Byrne, J., Wo, J.Y. (2019). Treatment of Localized Anal Cancer: Chemoradiotherapy. In: Meyer, J., Kachnic, L. (eds) Anal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-20253-8_4

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  • DOI: https://doi.org/10.1007/978-3-030-20253-8_4

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